Is COVID-19 that different in hemodialysis patients?: A single-center experience

Coronavirus disease 2019 (COVID-19) has affected millions worldwide, and in particular the care of patients on maintenance hemodialysis. These patients are thought to be at high risk of severe SARS-CoV-2 infection due to their older age and multiple comorbidities. The aim of this study was to compare hemodialysis and non-dialysis COVID-19 patients and find possible risk factors for mortality in hemodialysis patients. We developed a single-center retrospective cohort study, from March 1st to December 31st, 2020, that included maintenance hemodialysis patients hospitalized with laboratory confirmed SARS-CoV-2 infection, and age and sex propensity matched non-dialysis patients also hospitalized with a laboratory confirmed SARS-CoV-2 infection (1:1). A total of 34 hemodialysis patients were included, 70.6% male, mean age 76.5 years and on maintenance hemodialysis for 3.0 [0.5-23] years. At admission, 50.0% needed oxygen supply. Median hospital stay duration was 11.0 [5.8-17.0] days, and 38.2% developed bacterial superinfection. Maintenance hemodialysis patient mortality rate was 32.4%. When matched to the non-dialysis group, the hemodialysis group developed more often respiratory insufficiency (50.0% vs 8.8%, p<0.001) and had higher ferritin (1658.0 vs 623.5, p=0.004) and troponin T (130.0 vs 31.0, p<0.001) levels, whereas the non-dialysis group had higher transaminases levels. There was no statistical difference regarding hospitalization time, bacterial superinfection, or mortality between groups. When the logistic regression was performed, only bacterial superinfection was a predictor for mortality in hemodialysis COVID-19 patients (0.01 [0.00-0.26]). There was no difference in hospital stay nor in death rate between hemodialysis and non-dialysis COVID-19 patients. Despite these results, we must emphasize that mortality in the dialysis group was particularly high, with up to 32% of in-hospital mortality, and that bacterial superinfection has been shown to be an independent predictor of mortality. These results highlight the importance of interventions, such as full vaccination coverage, to mitigate the burden of COVID-19 in hemodialysis patients.

Download Full-text

The Weekend Effect in Maintenance Hemodialysis Patients: A Single-center Experience Study

Journal of Ankara University Faculty of Medicine ◽

10.4274/atfm.galenos.2021.94834 ◽

2021 ◽

Vol 74 (3) ◽

pp. 332-336

Author(s):

Gizem Kumru Şahin ◽

Göksel Murat Soylu

Keyword(s):

Hemodialysis Patients ◽

Weekend Effect ◽

Maintenance Hemodialysis ◽

Single Center ◽

Single Center Experience ◽

Maintenance Hemodialysis Patients

Download Full-text

Implantable cardioverter defibrillator in maintenance hemodialysis patients with ventricular tachyarrhythmias: A single-center experience

Hemodialysis International ◽

10.1111/j.1542-4758.2009.00330.x ◽

2009 ◽

Vol 13 (1) ◽

pp. 48-54 ◽

Cited By ~ 4

Author(s):

Itaru ITO ◽

Koichi KONO ◽

Goro SHINBO ◽

Kazuyoshi TADOKORO ◽

Chikara ABE ◽

...

Keyword(s):

Implantable Cardioverter Defibrillator ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Ventricular Tachyarrhythmias ◽

Single Center ◽

Cardioverter Defibrillator ◽

Single Center Experience ◽

Maintenance Hemodialysis Patients

Download Full-text

COVID-19 Prevention and Control in Dialysis Centers during the Pandemic: A Single-Center Experience

Blood Purification ◽

10.1159/000515668 ◽

2021 ◽

pp. 1-6

Author(s):

Liangying Gan ◽

Bing Yang ◽

Yan Wang ◽

Ying Wang ◽

Li Zuo

Keyword(s):

Prevention And Control ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Single Center ◽

Single Center Experience ◽

Key Points ◽

The World ◽

And Control ◽

Control Management ◽

Close Contacts

Coronavirus disease (COVID-19) is highly contagious and is now a tragic pandemic. Maintenance hemodialysis (MHD) patients are susceptible to COVID-19 and more prone to develop into severe cases because of the older age, heavy comorbidities, and impaired immunity. Patients who receive in-center dialysis have to travel to and from dialysis centers; patients have to share the dialysis hall with others during dialysis, making the prevention and control of COVID-19 in dialysis centers different from that in community and more difficult. This article provides key points in coping with COVID-19 in dialysis centers during this pandemic based on experience: (1) enforcing infection control management of dialysis centers, (2) training of hemodialysis patients and medical staffs, (3) screening for COVID-19 among patients and medical staffs, and (4) providing graded isolated dialysis to close contacts, suspected cases, and confirmed cases of COVID-19. We hope our single-center experience can be referenced by other dialysis centers around the world in coping with the COVID-19 pandemic.

Download Full-text

Implementation and effectiveness of an intensive education program on phosphate control among hemodialysis patients: a non-randomized, single-arm, single-center trial

BMC Nephrology ◽

10.1186/s12882-021-02441-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jinmei Yin ◽

Jun Yin ◽

Rongli Lian ◽

Peiqiu Li ◽

Jing Zheng

Keyword(s):

Education Program ◽

Hemodialysis Patients ◽

Serum Phosphorus ◽

Phosphate Binders ◽

Maintenance Hemodialysis ◽

Single Center ◽

Clinical Trial Registry ◽

Before And After ◽

Intensive Education ◽

Phosphate Control

Abstract Background Hyperphosphatemia is a common complication in patients on maintenance hemodialysis. Patients’ adherence to phosphorus control can be improved by consistent education. However, few studies have focused on the model construction and effects of health education on phosphate control for hemodialysis patients. Objective To develop an intensive education program focusing on phosphate control among hemodialysis patients and to analyze the effectiveness of this program. Design A non-randomized, single-arm, single-center trial lasting for 6 months. Setting This program was conducted in a hemodialysis center in a teaching hospital in Zhuhai, China. Participants Patients on maintenance hemodialysis with hyperphosphatemia. Methods An intensive hyperphosphatemia control education program lasting for 6 months was conducted among 366 hemodialysis patients applying the First Principles of Instruction model, which focused on mastering four stages: (a) activation of prior experience, (b) demonstration of skills, (c) application of skills and (d) integration of these skills into real-world activities. The controlled percentage of serum phosphorus, knowledge of hyperphosphatemia, and adherence to phosphate binders before and after the education program were assessed. Results The proportion of controlled serum phosphorus was significantly increased from 43.5 to 54.9% (P<0.001). The scores on the knowledge of phosphate control were improved significantly from 59.0 ± 18.9 to 80.6 ± 12.4 (P < 0.001). The proportion of high adherence to phosphate binders was increased dramatically from 21.9 to 44.5% (P < 0.001). Conclusion The intensive education program can effectively improve serum phosphorus, knowledge of hyperphosphatemia, and adherence to phosphate binders among hemodialysis patients. Trial registration Chinese Clinical Trial Registry, ChiCTR2100042017. Retrospectively registered January 12th, 2021.

Download Full-text